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Relieving Chronic Constipation

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8 Signs It’s Time to Step Up Your Constipation Treatment

Medically Reviewed By Cynthia Taylor Chavoustie, MPAS, PA-C
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Constipation is one of the most common gastrointestinal (GI) issues affecting U.S. adults. Many medications and products can help manage constipation, but you may need to step up constipation treatment before more serious problems, such as fecal impaction, occur.

The pain is worsening by the minute

People vary in how often they have a bowel movement — for some, they occur daily. Many others have bowel movements only about three times every week, and this is normal for them. Constipation is a decrease in your regular frequency of stools.

Left untreated, constipation can become a long-lasting condition that interferes with your quality of life. Recognizing the signs that constipation isn’t getting better allows you to work with your doctor to find effective forms of relief. 

Constipation symptoms and causes

Doctors usually diagnose constipation if you have fewer than three bowel movements every week. If you’re constipated, you may have a many symptoms, including:

  • a feeling that not all stool has passed when you use the bathroom
  • difficulty or pain while passing stools
  • stools that are dry, hard, or lumpy

There is no single reason constipation occurs. Instead, what causes constipation is usually a combination of several factors. Constipation may also result from the use of medications and dietary supplements, lifestyle changes, or nutrition and health problems. If you become constipated, think about whether you’ve recently changed any portion of your daily routine. This can help pinpoint a cause.

Other causes of constipation include functional GI disorders, like irritable bowel syndrome (IBS). In some cases, constipation occurs simply because the movement of stool through the colon slows down.

For instance, certain pelvic floor disorders cause a delay in how fast the colon, or large intestine, empties. Women are more likely to experience this issue, but it may also happen if you’ve recently had surgery. 

Should you change your constipation treatment?

When you’re first diagnosed, doctors typically recommend lifestyle changes to help get your bowels moving regularly again. This usually starts with diet — your doctor may suggest increasing your fiber and fluid intake to promote normal bowel movements. 

It can also be helpful to try to go to the bathroom after you eat or increase the amount of exercise you get during the day. Both behavioral changes can help your bowels move stool more regularly. Your doctor may suggest an over-the-counter (OTC) laxative or stool softener for a short period of time.

These techniques still aren’t enough to help some people. If you have any of the following symptoms, it’s time to seek medical attention:

  • blood in your stool
  • constant abdominal pain
  • fever
  • inability to pass gas
  • losing weight without trying
  • lower back pain
  • rectal bleeding
  • vomiting

These symptoms can indicate a larger problem is happening.

For some people, prescription medications are necessary. Prescription constipation drugs work by drawing more water into the colon, which promotes the regular passage of stool.

Severe, long-term constipation may lead to fecal impaction. Fecal impaction occurs when a hard, dry lump of stool gets stuck in your colon, making it impossible to push out. Impaction can cause serious health problems and even death if not treated promptly. 

If you have a fecal impaction, your doctor will probably recommend treatment using warm water enemas or mineral oil.

To perform this procedure, your doctor will have you lay down on your left side with your knees drawn up toward your chest. Your doctor inserts up to 10 ounces of warm water into your rectum and lower colon. This treatment often loosens the impaction enough that it will come out when the water is emptied from out the body.

In rarer cases, medications and enemas don’t work to relieve constipation. If this happens, doctors typically remove stool manually by inserting a gloved finger into the rectum and working the stool out.

Constipation can be uncomfortable, but most people can manage it on their own. However, if you experience any symptoms such as abdominal pain or rectal bleeding, it’s time to talk with your doctor. Such symptoms are a sign that you need more intensive constipation treatment. Your doctor can help you determine which therapies might work best for you.

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Medical Reviewer: Cynthia Taylor Chavoustie, MPAS, PA-C
Last Review Date: 2022 Oct 26
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